Table of Contents
Washington University Experience | NEOPLASMS (MENINGIOMA) | Gross Pathology | 21A0 Case 21 History
Case 21 History ---- The patient was a 64-year-old woman with a past medical history of recurrent meningioma, endometrial carcinoma, Parkinson disease and deep vein thrombosis. The patient was diagnosed 20 years previously with a meningioma which was resected with resultant left hemiparesis. She initially presented with seizures which continued after surgery. The meningioma recurred 10 years prior and was treated with radiation. She was diagnosed with uterine carcinoma 2 years prior to her death for which she had a total abdominal hysterectomy. The patient's previous left hemiparesis progressed to right hemiparesis in the year prior to her demise. At that time the patient returned with massive brain edema and impending herniation for which she was treated with steroids and discharged on supportive measures only. Two months later she was brought to the BJH ER after being found unconscious, unresponsive and lying in bed at home. Initial examination at the ER was remarkable for a right fronto-parietal mass with purulent drainage. The pupils were non-reactive. An initial head CT showed extensive skull erosion in the bilateral frontal and right frontal temporal region consistent with a large meningioma. There was extensive edema of the underlying brain with effacement of the sulci, ventricles and basal cistern. The patient was given continuous ventilatory support, pressors and antibiotics but surgical intervention was declined and she passed away
